Health information technology's (health IT's) ability to improve patient care and reduce cost is diminished by the inability to place targeted technologies into practice. Health IT characteristics, user preferences, organizational context and the payer/regulatory environment have all been found to affect health IT adoption and use. These factors have been studied intensely with explanatory models to predict their effect, with one exception: the payer/regulatory environment. Despite the apparent integral role payer/regulatory environment plays in health IT adoption, research on readiness of payer/regulators to support a targeted technology is limited. The payer/regulator's support for technology adoption is often considered an act of chance, as was the case with clinician behavior in the early stages of evidence-based practice research. An explanatory model of the role payers/regulators play in health IT adoption would clarify the payers' role and begin to broaden the scientific and practical knowledge of this poorly understood area. This proposal will test the Payer Readiness for Technology Implementation (P-RTI) assessment tool developed by PI Molfenter at the University of Wisconsin's Center for Health Enhancement Systems Studies (CHESS). This is self-contained health IT research project addressing the research area of interest of improving understanding of health IT use. This research project will focus on payer readiness for the adoption of two patient-centered health technologies, telephonic and video counseling, for patients with substance use disorders (SUDs). The SUD field was selected for this study because of the growing public health impact of SUDs and the slow adoption of health IT in this field. The P-RTI tool will be analyzed using a mixed methods approach to compare ten states' readiness for health IT implementation against the percentage of patients who receive clinical services from the targeted technologies. This self-contained health IT research project meets the intent of PAR-14-001 for the improved understanding of health IT applications by: 1) focusing on a challenge (lack of payer support) in health IT adoption and use; 2) filling a gap in the health IT evidence base by describing how payers can support health IT implementation; 3) addressing an area where health IT adoption lags (SUDs); 4) addressing an ARHQ priority population: the study's payers serve a low-income population; and 5) focusing on the research area of Use: by studying factors that lead to increased adoption and use of health IT.